Evidence map›Paper›PMID 27716843›Full record

ArticlePloS one2016

Long-Term Durability of Tenofovir-Based Antiretroviral Therapy in Relation to the Co-Administration of Other Drug Classes in Routine Clinical Practice.

Silvia Costarelli, Alessandro Cozzi-Lepri, Giuseppe Lapadula, Stefano Bonora, Giordano Madeddu, Franco Maggiolo, Andrea Antinori, Massimo Galli, Giovanni Di Perri, Pierluigi Viale and 3 more

Abstract read
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Lessons Learned from Liver-on-Chip Platform.Annals of biomedical engineering · 2025
    Review
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Silvia CostarelliDepartment of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
Alessandro Cozzi-LepriDepartment of Virology, Royal Free and University College Medical School, London, United Kingdom.
Giuseppe LapadulaDepartment of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
Stefano BonoraDepartment of Medical Sciences, University of Torino, Torino, Italy.
Giordano MadedduDepartment of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Sassari, Italy.
Franco MaggioloDepartment of Infectious Diseases, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Andrea AntinoriNational Institute for Infectious Diseases-IRCCS, Rome, Italy.
Massimo GalliDepartment of Clinical and Biomedical Sciences "Luigi Sacco", Section of Infectious Diseases, University of Milan, Milan, Italy.
Giovanni Di PerriDepartment of Medical Sciences, University of Torino, Torino, Italy.
Pierluigi VialeClinic of Infectious Diseases, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Antonella d'Arminio MonforteUnit of Infectious Diseases, Department of Health Sciences, University of Milan, Milan, Italy.
Andrea GoriDepartment of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
ICONA Foundation Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn clinical trials, toxicity leading to tenofovir disoproxil fumarate (TDF) discontinuation is rare (3% by 2 years); however in clinical practice it seems to be higher, particularly when TDF is co-administered with ritonavir-boosted protease inhibitors (PI/r). Aims of this study were to assess the rate of TDF discontinuations in clinical practice and to identify factors associated with the risk of stopping TDF.

methodsAll antiretroviral treatment (ART)-naive patients initiating a TDF-based regimen were selected from the ICONA Foundation Study cohort. The primary outcome was TDF discontinuation regardless of the reason; secondary outcome measures were TDF discontinuation due to toxicity and selective TDF discontinuation (that is, TDF discontinuation or substitution, maintaining unchanged the remaining antiretroviral treatment).

results3,618 ART-naïve patients were included: 54% started a PI/r-based and 46% a NNRTI-based based regimen. Two-hundred-seventy-seven patients discontinued TDF and reintroduced ART within 30 days without TDF. The probability of TDF discontinuation regardless of the reason was of 7.4% (95%CI:6.4-8.5) by 2 years and 14.1% (95%CI:12.2-16.1) by 5 years. The 5-year KM estimates in the PI/r vs. NNRTI group were 20.4% vs. 7.6%, respectively (log-rank p = 0.0001), for the outcome of stopping regardless of the reason, and 10.7% vs. 4.7% (p = 0.0001) for discontinuation due to toxicity. PI/r use and lower eGFR were associated with an increased risk of discontinuing TDF.

conclusionIn our cohort, the frequency of TDF discontinuations was higher than that observed in clinical trials. Co-administration of TDF with PI/r was associated with an increased rate of TDF discontinuations. Further studies are needed to clarify the mechanisms that might have led to this outcome.

Indexed as

AdultAnti-HIV AgentsDrug Therapy, CombinationFemaleHIV InfectionsHIV Protease InhibitorsHumansMaleMiddle AgedReverse Transcriptase InhibitorsRitonavirTenofovirAnti-HIV AgentsHIV Protease InhibitorsReverse Transcriptase InhibitorsRitonavirTenofovir

Identifiers

PMID27716843
PMCPMC5055315

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.